Honduras

Kevin had the opportunity to travel to Honduras this past week. He's back home and has written a summary of the work he and his friends were able to do.....

We arrived in Tegulcigalpa early saturday (flew all night friday). At the airport in Honduras we met our translators. There were also a group of about 15 nurses from Oklahoma Christian College who were doing a 2 week mission trip. We all got on a bus and drove to Catacamas. Catacamas is only about 70 miles away but it took us 4 hours with traffic. About 1/3 of the road was dirt, the rest was nice (although no painted lines and cars go 80+ MPH with horses, cows and pedestrians feet away).

Honduras looks like any other Central American country. It was hot (80-90s and humid) and dry. The people look different than Mexicans to me and they were very friendly for the most part. Their Spanish has an Italian sound to it. Hondruas looked a lot like Haiti but was a little better off, people had more clothes and didnt look as malnourished as in Haiti. The pollution and litter everywhere is hard to deal with. But they all have to drink bottled fluids and there are no garbage pick-ups. So trash, especially bottles, are everywhere.

On Monday we went to the main clinic. We were there as guests of Predisan.

Predisan is a Christian mission group that is only in Catacamas. It was the vision of a honduran doctor and now they have about 50 staff members. They have one large clinic and 5 rural clinics. I was contacted by MTI about needs in Predisan, that's how I learned about them. Predisan has 3 or 4 Land-Cruisers, a very nice clinic that has x-ray, ECG, colposcopy, lab, one surgical suite for when a surgey team is there, and 3 full-time Honduran physicians.

They see about 50-70 patients a day in the main clinic. It's not a hospital though, there are no over-night patients. There is a public hospital and a small Catholic hospital within 45 minutes of Catacamas but they are expensive. That's where they send the serious patients. Lorenzo ended up working with the Honduran doctors just seeing routine patients and teaching them our US protocols. He saw mostly diabetes and hypertension. Joe taught the nurses how to do pap smears (nurses do a lot of things there that only docs do in the US) and saw a lot of pregnant women. Amazingly, we

didn't see anything too severe. We had an easy week medically.

Honduras uses Limpiras, not dollars. One limpira is worth about 5 cents. They dont use coins, it's all paper money. Lunch would cost around 40 limpiras. So as you can see, $20 lasted me all week. The dollar goes very far there. It's cool to be able to tip people with a 20 bill and realize you just gave them a a week's pay. What's easy for us to give up can be a huge deal to them.

The first day we went about 45 minutes away to a church on top of a mountain. Lorenzo stayed at the main clinic and I decided to tag along with Joe.

Joe is an amazing guy. He is 71. He and his wife built a clinic in Haiti (the one I went to). He has been on dozens and dozens of trips like these. He is such a great example of a guy that decides to be obedient to Jesus. He's spent his life in the third world while all his friends are living in condos in Florida. He wants to live more comfortably, especially now that he is getting old, but his priorty is to serve others. He said he'll keep going on trips until he cant walk anymore. He has no fear and picks up languages quickly. Joe gave me a crash course in gynecology. I got to help with pap smears (fun). They needed a lot of education on what cervical cancer is. They don't realize it's caused by the HP-virus and that it's treatable if caught early. Cervical cancer is about the 15th cancer among US women but ranks #2 in developing countries. So yes, I learned how to do a pap smear and saw things that made me confident that gynecology was definitely not something I missed out on.

I also got to play with Joe's portable ultrasound. I could get the sex of the baby (took me forever compared to Joe) but only if it was in the first or second trimester, the later term ones are too hard.

The next day I spent in the lab. They actually have a very nice lab.

They have about a dozen tests they can do. Their lab tech is a nurse who was pretty good but didnt know the reasons for the things she did. My interpretor, Flavio, was a neat guy we had fun hanging out but even for the most fluent person, translating medicine is hard. About half the words aren't translatable so you end up saying things like 'ovals in blood' instead of 'hereditary ovalocytes' and then she would get confused and think I was talking about Ovale (a type of malaria), etc... It took 5 minutes to get one sentence across sometimes. Now that I know what the lab has and what they need I can help more if I go back.

The third day we went to the mountains. It was about 2.5 hours away. We got 10 people in the landcruiser. It was packed. It had AC but the dirt roads and potholes were tough. Lorenzo and I were getting carsick, (nothing bothers Joe, this was a vacation for him compared to Haiti). I don't like being squished and I dont like the back seat of cars. But there are a lot of moments when you just have to try and test yourself and see what you can handle, see how strong you are (that's how I endure that kind of stuff, I have to make a challenge for myself and think "let's see if I can do this without letting myself get wimpy") -otherwise I just complain, but if I make it a sort of personal challenge then I can get through it. That morning I had a really bad GI issue. Despite being very careful I got some kind of infection (massive diarrhea and GI cramping). I thought there was no way I could ride in a car for 2.5 hours one way bouncing around. But we prayed, I got in the car, and I was fine. In my experience, people dont recover from those symptoms in 4 hours but I did. I was fine by the time we got to the rural clinic. I chalk that up to healing from God.

At the rural clinics Lorenzo and Joe did Gyn checks on the female nurse staff. They had assembled the nurses from all 5 clinics to meet at the one, closest clinic. Then we taught them how to interpret lab tests. They send some samples to the lab in Catacamas (sending a blood sample 2 hours via bumpy hot roads is not a good idea). Some patients come to the rural clinics with results from other labs as well. The nurses dont know how to interpret these labs and don't know what is serious and what is not. So we spent some time teaching.

I also made Flavio find us a machete so we could cut some sugar cane and eat it.

We saw lots of plantains, cocnuts, lemons, limes and sugar cane.

Flavio found a press that squeezes sugar cane. A foot-long piece gave about 2 cups of juice. It was good, like pure sugar mixed with tea.

A dead armadillo was the only cool animal I saw. I really wanted to see a Fer-de-lance (one of the deadliest snakes in the world) but they are rare.

The next day we were at the clinic. I spent time showing Marta (the lab tech) how to find malaria with a microscope and also how to look for parasite eggs in stool. A lot of the kids have worms there. Probably 80%. We did see a lot of malnutrition but not as bad as Haiti. I also spent half the day with Lorenzo getting some experience with patients. Marta gave me a mango, maybe it was from her garden, it was my dessert. The food there was the same every night. They don't have much dairy and chocolate, or anything that had to be refrigerated, was hard to find. I ate rice, beans and beef every day. The mango was good.

Our hotel was very nice, nicer than most US hotels. We had AC and hot water. We felt guilty staying there (the nurses from Oklahoma were in tents in the mountains). We were the only guests in the hotel, but we were close to the clinic. The economy is bad in Honduras too.

One night at the hotel around 6pm, while we were eating some ballanderas (a kind of giant burrito with eggs, beef and beans) we heard gunshots. Probably over 100 rounds. We went inside. The next morning all the folks were talking about 6 drug dealers that were killed 3 blocks from our hotel. We saw their bullet-ridden cars. A cop was shot too, and they brought him to the clinic. There is no trauma service at the Predisan clinic but they couldnt bring him to the public hospital because the drug gangs were waiting for him there so they could finish him off. The docs sent the injured cop away, in disguise, to another hospital. He was shot in the gut and needed surgery. The police have heavy duty machine guns, vests, etc. And are very intimidating looking. Police corruption is a problem. They assured me that gunfights like this was not normal.

They had a very nice send off for us, and seemed really glad that we came. They kept asking if we would come back. I really like Flavio (he wants to come to America and attend seminary), he and his wife are expecting their first baby this fall. The other translators and staff were nice too. I think it's the kind of place you could back and really build relationships. I'm thinking about going back this winter. Lorenzo and I kept thinking about building a school down there. Perhaps a nursing school or lab-tech school or a grade-school. Maybe near the coast (there is a town called San Lorenzo that has a lot of need, a high poverty region), maybe the city's name is a sign for Lorenzo?